Forum - Questions & Answers

Jan 18th, 2011 - tdavis4724

CPT® not allowed w/same date of service ( Physician Bill)

I have a patient with dx: 263.9, 276.1, 533.90
CPT® codes 44005, 36556, and 43632. The CCI Edit says CPT® not allowed with same date of service. Modifier may or may not be needed. I am trying to bill the claim out but I am not sure how to correct it. The CCI edit applies to 44005 & 36556. Any suggestions?

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Jan 20th, 2011 - jschmutz   323 

44005 is a separate procedure

You can read in the CPT® book about separate procedures.

44005 bundles with 43632 and there are no circumstances in which a modifier would be appropriate to unbundle this combination.

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Jan 21st, 2011 -

44005 and 43632?

So the 44005 should be removed and just use 43632?

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